Additional Information
Book Details
Abstract
Widely recognized as the world’s leading dermatology manual, the new edition of Habif’s Clinical Dermatology has been exhaustively updated to reflect today’s best practices. A wealth of new features makes it easier, than any other resource, to identify, treat, and manage the full range of skin diseases.
- Presents outstanding photographs for virtually every common skin disorder.
- Organizes disease information with a Disorders Index on the inside front cover, allowing for quick access to specific guidance, and a brand new Regional Diagnosis Atlas in chapter 1.
- Uses a consistent format in every chapter to present information in a logical, easy-reference fashion.
- Features extensive revisions throughout that highlight the newest developments in diagnosis and treatment, giving you the absolute latest on virtually every skin disorder.
- Over 1000 full color photographs, incorporating 500 brand-new, never-before-published images for enhanced visual diagnostic guidance.
- Offers expanded material on non-white skin that prepares you to diagnose and treat different patient populations.
- Provides coverage of tropical diseases to help you treat patients who have been traveling abroad.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front cover | Cover | ||
Disorders index | IFC1 | ||
Quick reference formulary | ii | ||
Copyright | vi | ||
Front matter | v | ||
Clinical dermatology | v | ||
Preface | vii | ||
Rapid access to the text | vii | ||
PMID numbers (pubmed identification numbers) | vii | ||
Web-based text | vii | ||
Web-based formulary | vii | ||
Text organization and content | vii | ||
How to use this book | vii | ||
Students in the classroom | vii | ||
Students in the clinic | vii | ||
The non-dermatologist provider | viii | ||
The dermatologist | viii | ||
Images | viii | ||
Production | viii | ||
Table of contents | ix | ||
Skin anatomy | xii | ||
Chapter\t| 1 | Principles of diagnosis and anatomy | 1 | ||
Skin anatomy | 1 | ||
Epidermis | 1 | ||
Dermis | 1 | ||
Dermal nerves and vasculature | 1 | ||
Diagnosis of skin disease | 2 | ||
A methodical approach | 2 | ||
Examination technique | 2 | ||
Approach to treatment | 2 | ||
Primary lesions | 2 | ||
Secondary lesions | 2 | ||
Chapter\t| 2 | Topical therapy and topical corticosteroids | 75 | ||
Topical therapy | 75 | ||
Emollient creams and lotions | 75 | ||
Severe dry skin (xerosis) | 75 | ||
Wet dressings | 76 | ||
Topical corticosteroids | 77 | ||
Strength | 77 | ||
Megapotent topical steroids (group I) | 78 | ||
Concentration. | 78 | ||
Compounding. | 78 | ||
Generic versus brand names. | 78 | ||
Vehicle | 78 | ||
Steroid-antibiotic mixtures | 79 | ||
Amount of cream to dispense | 79 | ||
Application | 80 | ||
Frequency | 80 | ||
Tachyphylaxis. | 80 | ||
Intermittent dosing | 80 | ||
Group I topical steroids. | 80 | ||
Groups II through VII topical steroids. | 80 | ||
Methods | 80 | ||
Simple application. | 80 | ||
Occlusion. | 80 | ||
Method of occlusion. | 80 | ||
Systemic absorption | 82 | ||
Avoid weaker, “safe” preparations. | 82 | ||
Children. | 82 | ||
Adults. | 82 | ||
Adverse reactions | 82 | ||
Steroid rosacea and perioral dermatitis | 82 | ||
Management. | 83 | ||
Atrophy | 85 | ||
Occlusion. | 87 | ||
Mucosal areas. | 87 | ||
Steroid injection sites. | 87 | ||
Long-term use. | 88 | ||
Alteration of infection | 88 | ||
Tinea incognito. | 88 | ||
Infestations and bacterial infections. | 88 | ||
Contact dermatitis | 90 | ||
Topical steroid allergy | 90 | ||
Management. | 90 | ||
Patch testing. | 90 | ||
Glaucoma | 90 | ||
Chapter\t| 3 | Eczema and hand dermatitis | 91 | ||
Stages of eczematous inflammation | 91 | ||
Acute eczematous inflammation | 93 | ||
Subacute eczematous inflammation | 94 | ||
Adult-onset recalcitrant eczema and malignancy | 97 | ||
Chronic eczematous inflammation | 98 | ||
Hand eczema | 100 | ||
Irritant contact dermatitis | 101 | ||
Atopic hand dermatitis | 103 | ||
Allergic contact dermatitis | 104 | ||
Nummular eczema | 104 | ||
Lichen simplex chronicus | 104 | ||
Recurrent focal palmar peeling | 105 | ||
Hyperkeratotic eczema | 105 | ||
Fingertip eczema | 107 | ||
Pompholyx | 109 | ||
Id reaction | 109 | ||
Eczema: Various presentations | 110 | ||
Asteatotic eczema | 110 | ||
Nummular eczema | 111 | ||
Chapped fissured feet | 113 | ||
Self-inflicted dermatoses | 115 | ||
Lichen simplex chronicus | 115 | ||
Chronic vulvar itching | 118 | ||
Red scrotum syndrome | 118 | ||
Treatment. | 118 | ||
Prurigo nodularis | 119 | ||
Neurotic excoriations | 120 | ||
Psychogenic parasitosis | 121 | ||
Stasis dermatitis and venous ulceration: Postphlebitic syndromes | 122 | ||
Stasis dermatitis | 122 | ||
Types of eczematous inflammation | 122 | ||
Subacute inflammation | 122 | ||
Acute inflammation | 122 | ||
Chronic inflammation | 123 | ||
Treatment of stasis dermatitis | 123 | ||
Topical steroids and wet dressings. | 123 | ||
Venous leg ulcers | 124 | ||
Management of venous ulcers | 126 | ||
Initial evaluation and treatment. | 126 | ||
Varicose veins. | 126 | ||
Laboratory evaluation. | 127 | ||
Function studies. | 127 | ||
Treatment. | 128 | ||
Leg elevation. | 128 | ||
Inflammation surrounding the ulcer. | 128 | ||
Systemic antibiotics. | 128 | ||
Topical antibiotics. | 128 | ||
Debridement of ulcer bed. | 128 | ||
Wound debridement. | 128 | ||
Occlusive dressings. | 128 | ||
Chemical debridement. | 128 | ||
Surgical or mechanical debridement. | 128 | ||
Definitive treatment | 129 | ||
Compression. | 129 | ||
Compression bandages. | 129 | ||
Graded elastic compression stockings. | 129 | ||
Nonelastic bandages. | 129 | ||
Pneumatic compression pumps. | 129 | ||
Aspirin. | 129 | ||
Pentoxifylline. | 129 | ||
Vitamins. | 129 | ||
Grafting. | 129 | ||
Vein surgery. | 129 | ||
Chapter\t| 4 | Contact dermatitis and patch testing | 130 | ||
Irritant contact dermatitis | 131 | ||
Allergic contact dermatitis | 133 | ||
Phases | 133 | ||
Sensitization phase | 133 | ||
Elicitation phase | 133 | ||
Cross-sensitization | 133 | ||
Systemically induced allergic contact dermatitis | 133 | ||
Clinical presentation | 135 | ||
Allergic contact dermatitis in children | 136 | ||
Management of allergic contact dermatitis | 136 | ||
Rhus dermatitis | 138 | ||
Natural rubber latex allergy | 140 | ||
Types of reactions | 140 | ||
Irritant contact dermatitis. | 140 | ||
Allergic contact dermatitis (type IV allergy). | 140 | ||
Chapter\t| 5 | Atopic dermatitis | 154 | ||
Pathogenesis and immunology | 156 | ||
Clinical aspects | 156 | ||
Infant phase (birth to 2 years) | 158 | ||
Childhood phase (2 to 12 years) | 162 | ||
Adult phase (12 years to adult) | 166 | ||
Associated features | 167 | ||
Dry skin and xerosis | 167 | ||
Ichthyosis vulgaris | 167 | ||
Keratosis pilaris | 168 | ||
Hyperlinear palmar creases | 170 | ||
Pityriasis alba | 170 | ||
Atopic pleats | 170 | ||
Cataracts | 170 | ||
Triggering factors | 172 | ||
Temperature change and sweating | 172 | ||
Decreased humidity | 172 | ||
Excessive washing | 172 | ||
Contact with irritating substances | 172 | ||
Contact allergy | 172 | ||
Aeroallergens | 172 | ||
Microbic agents | 172 | ||
Food | 172 | ||
Emotional stress | 172 | ||
Treatment of atopic dermatitis | 172 | ||
Dry skin | 174 | ||
Inflammation and infection | 174 | ||
Pimecrolimus cream 1% (elidel) | 175 | ||
Chapter\t| 6 | Urticaria and angioedema | 181 | ||
Clinical aspects | 182 | ||
Pathophysiology | 185 | ||
Initial evaluation of all patients with urticaria | 186 | ||
Acute urticaria | 186 | ||
Chronic urticaria | 188 | ||
Differential diagnosis | 188 | ||
Treatment of urticaria | 191 | ||
Approach to treatment | 191 | ||
First-line therapy | 191 | ||
Antihistamines. | 191 | ||
Mechanism of action. | 191 | ||
Initiation of treatment. | 191 | ||
Side effects. | 191 | ||
Long-term administration. | 191 | ||
H1 and H2 antihistamines. | 191 | ||
First-generation (sedating) H1 antihistamines. | 191 | ||
Second-generation (low-sedating) H1 antihistamines. | 191 | ||
Fexofenadine (allegra). | 191 | ||
Cetirizine (zyrtec). | 192 | ||
Loratadine (claritin). | 193 | ||
Desloratadine (clarinex). | 193 | ||
Tricyclic antihistamines (doxepin). | 193 | ||
Epinephrine. | 193 | ||
Second-line agents | 193 | ||
Oral corticosteroids. | 193 | ||
Leukotriene modifiers. | 193 | ||
Dapsone. | 193 | ||
Calcineurin inhibitors. | 193 | ||
Third-line agents | 193 | ||
Intravenous immunoglobulin. | 193 | ||
Methotrexate. | 193 | ||
Topical measures. | 193 | ||
Physical urticarias | 194 | ||
Dermographism | 194 | ||
Pressure urticaria | 196 | ||
Cholinergic urticaria | 197 | ||
Exercise-induced anaphylaxis | 198 | ||
Cold urticaria | 198 | ||
Solar urticaria | 199 | ||
Pathogenesis | 199 | ||
Heat, water, and vibration urticarias | 199 | ||
Aquagenic pruritus | 199 | ||
Angioedema | 200 | ||
Acquired forms of angioedema | 200 | ||
Acquired angioedema (C1 INH deficiency syndromes) | 204 | ||
Episodic angioedema-eosinophilia syndrome. | 204 | ||
Hereditary angioedema | 204 | ||
Contact urticaria syndrome | 207 | ||
Pruritic urticarial papules and plaques of pregnancy | 207 | ||
Urticarial vasculitis | 209 | ||
Serum sickness | 210 | ||
Mastocytosis | 211 | ||
Spectrum of disease | 211 | ||
Cutaneous mastocytosis | 211 | ||
Solitary mastocytoma. | 212 | ||
Urticaria pigmentosa. | 212 | ||
Telangiectasia macularis eruptiva perstans (TMEP). | 214 | ||
Diffuse cutaneous types. | 214 | ||
Systemic mastocytosis | 214 | ||
Diagnosis. | 215 | ||
Diagnostic criteria for systemic mastocytosis. | 215 | ||
Diagnosis. | 216 | ||
Skin disease. | 216 | ||
Blood and urine studies. | 216 | ||
Prognosis. | 216 | ||
Management. | 216 | ||
Cutaneous disease. | 216 | ||
Systemic disease treatment. | 216 | ||
Reduce mast cell burden. | 216 | ||
Chapter\t| 7 | Acne, rosacea, and related disorders | 217 | ||
Acne | 217 | ||
Classification | 219 | ||
Etiology and pathogenesis | 223 | ||
Approach to acne therapy | 225 | ||
Initial visit | 225 | ||
History. | 225 | ||
Pathogenesis and course. | 225 | ||
Acne and diet. | 225 | ||
Cosmetics and cleansers. | 225 | ||
Oral contraceptives. | 225 | ||
Initial evaluation | 225 | ||
Type of lesions. | 225 | ||
Degree of skin sensitivity. | 225 | ||
Selection of therapy. | 225 | ||
Course of treatment. | 225 | ||
Acne treatment | 226 | ||
Comedonal acne | 226 | ||
Clinical presentation. | 226 | ||
Treatment. | 226 | ||
Mild inflammatory acne | 227 | ||
Clinical presentation. | 227 | ||
Treatment. | 227 | ||
Moderate-to-severe inflammatory acne | 228 | ||
Clinical presentation. | 228 | ||
Treatment. | 228 | ||
Severe: Nodulocystic acne | 230 | ||
Clinical presentation. | 230 | ||
Cystic acne | 230 | ||
Pyoderma faciale. | 230 | ||
Acne fulminans | 230 | ||
Acne conglobata | 234 | ||
Treatment of nodulocystic acne | 234 | ||
Therapeutic agents for treatment of acne | 235 | ||
Retinoids | 235 | ||
Tretinoin. | 235 | ||
Tazarotene. | 235 | ||
Adapalene. | 236 | ||
Azelaic acid. | 236 | ||
Benzoyl peroxide | 236 | ||
Benzoyl peroxide/antibiotic formulations. | 236 | ||
Principles of treatment. | 236 | ||
Allergic reaction. | 236 | ||
Drying and peeling agents | 236 | ||
Topical antibiotics | 237 | ||
Oral antibiotics | 237 | ||
Mechanism of action and dosage. | 237 | ||
Antibiotic-resistant propionibacteria and long-term therapy. | 237 | ||
Long-term treatment. | 237 | ||
Dosage and duration. | 237 | ||
Tetracycline. | 237 | ||
Dosing. | 237 | ||
Adverse effects. | 237 | ||
Doxycycline. | 238 | ||
Chapter\t| 8 | Psoriasis and other papulosquamous diseases | 264 | ||
Psoriasis | 264 | ||
Pathogenesis | 264 | ||
Clinical manifestations | 265 | ||
Drugs that precipitate or exacerbate psoriasis | 266 | ||
Lithium. | 266 | ||
Beta-blocking agents. | 266 | ||
Antimalarial agents. | 266 | ||
Systemic steroids. | 266 | ||
Comorbidities associated with psoriasis | 267 | ||
Clinical presentations | 267 | ||
Chronic plaque psoriasis | 267 | ||
Guttate psoriasis | 268 | ||
Generalized pustular psoriasis | 269 | ||
Erythrodermic psoriasis | 269 | ||
Light-sensitive psoriasis | 270 | ||
Psoriasis of the scalp | 270 | ||
Psoriasis of the palms and soles | 270 | ||
Pustular psoriasis of the palms and soles | 270 | ||
Keratoderma blennorrhagicum (Reiter syndrome) | 272 | ||
Psoriasis of the penis and Reiter syndrome | 273 | ||
Pustular psoriasis of the digits | 273 | ||
Psoriasis inversus (psoriasis of the flexural or intertriginous areas) | 274 | ||
Human immunodeficiency virus (HIV)–induced psoriasis | 274 | ||
Psoriasis of the nails | 275 | ||
Psoriatic arthritis | 276 | ||
Defining PsA | 276 | ||
Differentiating PsA and RA | 279 | ||
Differentiating PsA from osteoarthritis (OA) and gout | 279 | ||
Treatment of psoriasis | 280 | ||
Topical therapy | 282 | ||
Calcipotriene (dovonex) | 282 | ||
Calcitrol (vectical) | 282 | ||
Retinoids | 282 | ||
Topical steroids | 282 | ||
Intralesional steroids | 283 | ||
Anthralin | 283 | ||
Preparations and use. | 283 | ||
Short-contact therapy. | 283 | ||
Ultraviolet light B | 284 | ||
Ultraviolet light B and lubricating agents. | 284 | ||
Ultraviolet light B and systemic agents. | 284 | ||
Narrow-band ultraviolet light B (NB-UVB). | 284 | ||
Photochemotherapy | 284 | ||
PUVA combined with other modalities. | 285 | ||
PUVA plus acitretin. | 285 | ||
Long-term side effects. | 285 | ||
Skin tumors. | 285 | ||
Lentigines. | 285 | ||
Cataracts. | 285 | ||
Short-term side effects. | 285 | ||
Nausea. | 285 | ||
Phototoxicity. | 285 | ||
Tape or occlusive dressings | 285 | ||
Treating the scalp | 285 | ||
Removing scale. | 286 | ||
Mild to moderate scalp involvement. | 286 | ||
Treatment of diffuse and thick scalp psoriasis. | 286 | ||
Tar and oil. | 286 | ||
Anthralin. | 286 | ||
Systemic therapy | 286 | ||
Rotational therapy | 286 | ||
Methotrexate (see boxes 8-2 to 8-10) | 287 | ||
Indications. | 287 | ||
Mechanism of action. | 287 | ||
Dosing. | 287 | ||
Monitoring. | 287 | ||
Side effects. | 287 | ||
Folic and folinic acid supplements. | 287 | ||
Liver fibrosis, cirrhosis, and biopsy interval. | 291 | ||
Liver biopsy. | 291 | ||
Lung toxicity. | 291 | ||
Recall of sunburn. | 291 | ||
Pregnancy. | 291 | ||
Drug interactions. | 291 | ||
Retinoids | 292 | ||
Acitretin. | 292 | ||
Indications. | 292 | ||
Dosing strategy. | 292 | ||
Acitretin and ultraviolet light B and PUVA. | 292 | ||
Laboratory changes. | 292 | ||
Side effects. | 292 | ||
Isotretinoin | 292 | ||
Cyclosporine (see boxes 8-14 to 8-17) | 294 | ||
Baseline monitoring. | 294 | ||
Kidney function and creatinine. | 294 | ||
Hypertension. | 294 | ||
Liver function. | 296 | ||
Other chemistries. | 296 | ||
Other side effects. | 296 | ||
Dosage. | 296 | ||
Low-dose approach. | 296 | ||
High-dose approach. | 296 | ||
Intermittent short courses. | 296 | ||
Response to treatment. | 297 | ||
Contraindications. | 297 | ||
Drug interactions. | 297 | ||
Combination therapy. | 297 | ||
Rotational therapy | 297 | ||
Other systemic drugs for psoriasis | 297 | ||
Biologic therapy for psoriasis | 306 | ||
Vaccines | 306 | ||
TNF-α inhibitors for the treatment of psoriasis | 306 | ||
Adalimumab. | 306 | ||
Etanercept. | 306 | ||
Pediatric psoriasis. | 307 | ||
Infliximab | 307 | ||
Biologics that target pathogenic T cells | 308 | ||
Alefecept. | 308 | ||
Biologics that target cytokines interleukin (IL)-12 and IL-23 | 308 | ||
Pityriasis rubra pilaris | 309 | ||
Seborrheic dermatitis | 312 | ||
Infants (cradle cap) | 312 | ||
Young children (tinea amiantacea and blepharitis) | 312 | ||
Adolescents and adults (classic seborrheic dermatitis) | 314 | ||
Acquired immunodeficiency syndrome | 315 | ||
Treatment of seborrheic dermatitis | 315 | ||
Shampoos. | 315 | ||
Topical steroids. | 315 | ||
Antiyeast medications. | 315 | ||
Oral antifungals. | 315 | ||
Other topicals. | 315 | ||
Pityriasis rosea | 316 | ||
Lichen planus | 320 | ||
Localized papules | 322 | ||
Hypertrophic lichen planus | 322 | ||
Generalized lichen planus and lichenoid drug eruptions | 322 | ||
Lichen planus of the palms and soles | 322 | ||
Follicular lichen planus | 322 | ||
Oral and genital lichen planus | 324 | ||
Erosive vaginal lichen planus | 324 | ||
Nails | 325 | ||
Diagnosis | 325 | ||
Treatment | 326 | ||
Therapy for cutaneous lichen planus | 326 | ||
Therapy of mucous membrane lichen planus | 326 | ||
Lichen sclerosus et atrophicus | 327 | ||
Pityriasis lichenoides | 332 | ||
Grover’s disease | 334 | ||
Chapter\t| 9 | Bacterial infections | 335 | ||
Skin infections | 335 | ||
Impetigo | 335 | ||
Bullous impetigo | 336 | ||
Clinical manifestations. | 336 | ||
Nonbullous impetigo | 338 | ||
Acute nephritis | 340 | ||
Laboratory findings. | 340 | ||
Prevention of impetigo | 340 | ||
Recurrent impetigo | 341 | ||
Treatment of impetigo | 341 | ||
Oral antibiotics. | 342 | ||
Mupirocin (bactroban). | 342 | ||
Retapamulin (altabax). | 342 | ||
Cellulitis and erysipelas | 342 | ||
Diagnosis of cellulitis | 342 | ||
Cellulitis vs. deep vein thrombosis. | 342 | ||
Cultures. | 343 | ||
Treatment of cellulitis | 345 | ||
Adults. | 345 | ||
Preventing recurrent cellulitis | 346 | ||
Prophylactic antibiotics to prevent recurrence. | 346 | ||
Children. | 346 | ||
Cellulitis of specific areas | 346 | ||
Cellulitis and erysipelas of the extremities | 346 | ||
Chapter\t| 10 | Sexually transmitted bacterial infections | 382 | ||
Sexually transmitted disease presentations | 382 | ||
Genital ulcers | 385 | ||
Developed countries | 385 | ||
Syndromic management of sexually transmitted diseases | 387 | ||
World health organization (WHO). | 387 | ||
Venereal warts | 395 | ||
Chemical (self-applied by patient) | 395 | ||
Chemical (provider administered) | 395 | ||
Physical | 395 | ||
Vaginal warts | 395 | ||
Cervical warts | 395 | ||
Meatal and urethral warts | 395 | ||
Syphilis | 396 | ||
Incidence | 396 | ||
Stages | 396 | ||
Risk of transmission | 397 | ||
T. pallidum | 397 | ||
Primary syphilis | 398 | ||
Secondary syphilis | 400 | ||
Lesions | 400 | ||
Latent syphilis | 402 | ||
Tertiary syphilis | 402 | ||
Syphilis and human immunodeficiency virus | 402 | ||
Congenital syphilis | 403 | ||
Early congenital syphilis | 403 | ||
Late congenital syphilis | 403 | ||
Syphilis serology | 403 | ||
Venereal disease research laboratory and rapid plasma reagin tests | 405 | ||
Quantitative testing. | 405 | ||
False-positive reactions. | 405 | ||
Prozone phenomenon. | 405 | ||
Fluorescent treponemal antibody absorption and T. pallidum particle agglutination tests | 405 | ||
Tests for neurosyphilis | 406 | ||
Patients with human immunodeficiency virus | 406 | ||
Treatment of syphilis | 406 | ||
Jarisch-Herxheimer reaction | 406 | ||
Management of the patient with a history of penicillin allergy | 406 | ||
Posttreatment evaluation of syphilis | 406 | ||
Serologic response to treatment | 406 | ||
Late latent syphilis | 407 | ||
Frequency of follow-up serologic tests | 407 | ||
Reinfection in primary, secondary, and latent syphilis | 407 | ||
Rare sexually transmitted diseases | 408 | ||
Lymphogranuloma venereum | 408 | ||
Primary lesions | 408 | ||
Inguinal stage | 408 | ||
Genitoanorectal syndrome | 409 | ||
Diagnosis | 409 | ||
Chlamydia tests. | 409 | ||
Management | 409 | ||
Drug regimen. | 409 | ||
Lesion management. | 409 | ||
Chancroid | 410 | ||
Bacteria | 410 | ||
Primary state | 411 | ||
Lymphadenopathy | 411 | ||
Diagnosis | 411 | ||
Culture | 411 | ||
Gram stain | 411 | ||
Treatment | 411 | ||
Granuloma inguinale (donovanosis) | 412 | ||
Clinical presentation | 412 | ||
Diagnosis | 412 | ||
Treatment | 412 | ||
Diseases characterized by urethritis and cervicitis | 413 | ||
Gonorrhea | 413 | ||
Neisseria gonorrhoeae | 413 | ||
Genital infection in males | 413 | ||
Urethritis. | 413 | ||
Diagnosis. | 413 | ||
Genital infection in females | 414 | ||
Cervicitis. | 414 | ||
Urethritis. | 414 | ||
Bartholin ducts. | 414 | ||
Diagnosis. | 414 | ||
Pelvic inflammatory disease | 414 | ||
Clinical presentation. | 414 | ||
Chapter\t| 11 | Sexually transmitted viral infections | 419 | ||
Genital warts | 419 | ||
Human papillomavirus | 419 | ||
Incidence | 419 | ||
Transmission | 419 | ||
Clinical presentation | 420 | ||
Oral condyloma in patients with genital human papillomavirus infection | 423 | ||
Pearly penile papules | 423 | ||
Genital warts in children | 424 | ||
Genital warts and cancer | 424 | ||
Diagnosis | 424 | ||
Treatment | 424 | ||
Management of sexual partners | 424 | ||
Pregnancy | 425 | ||
Children | 425 | ||
Patient-applied therapies | 425 | ||
Imiquimod. | 425 | ||
Podofilox. | 425 | ||
Provider-administered therapies | 425 | ||
Cryosurgery. | 425 | ||
Surgical removal and electrosurgery. | 425 | ||
Trichloroacetic acid. | 425 | ||
Podophyllum resin. | 426 | ||
Warning. | 426 | ||
Alteration of histopathology. | 426 | ||
5-fluorouracil cream. | 426 | ||
Carbon dioxide laser. | 427 | ||
Interferon alfa-2b recombinant (Intron A). | 427 | ||
Bowenoid papulosis | 427 | ||
Molluscum contagiosum | 428 | ||
Clinical manifestations | 428 | ||
Diagnosis | 428 | ||
Treatment | 430 | ||
Over-the-counter treatments | 430 | ||
Curettage | 430 | ||
Cryosurgery | 430 | ||
Antiviral and immunomodulatory therapies | 430 | ||
Cantharidin | 430 | ||
Potassium hydroxide | 430 | ||
Oral cimetidine | 430 | ||
Laser therapy | 430 | ||
Trichloroacetic acid peel | 430 | ||
Genital herpes simplex | 431 | ||
Prevalence | 431 | ||
Risk factors | 431 | ||
Rate of transmission | 435 | ||
Previous herpes simplex virus type 1 infection | 435 | ||
Human immunodeficiency virus infection | 435 | ||
Primary and recurrent infections | 435 | ||
First-episode infections | 435 | ||
Signs and symptoms. | 435 | ||
Recurrent infection | 436 | ||
Clinical signs and symptoms. | 436 | ||
Frequency of recurrence. | 436 | ||
Anatomic site. | 436 | ||
Asymptomatic transmission. | 436 | ||
Asymptomatic shedding. | 436 | ||
Prevention | 437 | ||
Laboratory diagnosis | 437 | ||
Polymerase chain reaction | 437 | ||
Culture | 437 | ||
Histopathologic studies | 437 | ||
Serology | 437 | ||
Subtyping | 437 | ||
Herpes simplex virus type 1. | 437 | ||
Type-specific serologic tests | 438 | ||
Indications to test | 438 | ||
Pregnant women. | 438 | ||
Monogamous couples. | 438 | ||
Diagnosis of recurrent genital eruptions. | 438 | ||
Identifying herpes simplex virus as a risk factor for human immunodeficiency virus transmission. | 438 | ||
Psychosocial implications | 438 | ||
Treatment of genital herpes (CDC guidelines) | 439 | ||
Drugs | 439 | ||
First clinical episode of genital herpes | 440 | ||
Cool compresses | 440 | ||
Counseling | 440 | ||
Recurrent episodes of herpes simplex virus disease | 441 | ||
Daily suppressive therapy | 441 | ||
Lubrication | 441 | ||
Genital herpes simplex during pregnancy | 441 | ||
Pregnancy complications | 441 | ||
Prenatal screening and management | 441 | ||
Prevention | 441 | ||
Antiviral therapy | 442 | ||
Viral cultures | 442 | ||
Management at labor | 442 | ||
Neonatal herpes simplex virus infection | 442 | ||
Clinical signs | 442 | ||
Diagnosis | 442 | ||
Prognosis | 443 | ||
Treatment | 443 | ||
Acquired immunodeficiency syndrome | 444 | ||
Human immunodeficiency virus pathogenesis | 444 | ||
CD4+ T-lymphocyte destruction leads to infection | 444 | ||
The initial human immunodeficiency virus infection | 444 | ||
The evolution of disease | 444 | ||
Progression to acquired immunodeficiency syndrome | 444 | ||
Diagnosis | 445 | ||
Viral burden | 445 | ||
Assessment of immune status (CD4+ T-cell determinations) | 445 | ||
Revised CDC classification and management | 446 | ||
Incidence | 446 | ||
Dermatologic diseases associated with human immunodeficiency virus infection | 446 | ||
Chapter\t| 12 | Warts, herpes simplex, and other viral infections | 454 | ||
Warts | 454 | ||
Clinical infection | 454 | ||
Immunologic response | 455 | ||
Treatment | 455 | ||
Warts: The primary lesion | 456 | ||
Common warts | 457 | ||
Treatment of recalcitrant warts | 458 | ||
Imiquimod. | 458 | ||
Apple cider vinegar. | 458 | ||
Filiform and digitate warts | 458 | ||
Flat warts | 459 | ||
Plantar warts | 460 | ||
Subungual and periungual warts | 464 | ||
Molluscum contagiosum | 465 | ||
Herpes simplex | 467 | ||
Primary infection | 467 | ||
Lesions | 467 | ||
Recurrent infection | 468 | ||
Oral-labial herpes simplex | 469 | ||
Primary infection | 469 | ||
Recurrent infection | 469 | ||
Treatment. | 469 | ||
Combination treatment. | 471 | ||
Topical treatment. | 471 | ||
Cutaneous herpes simplex | 471 | ||
Eczema herpeticum | 473 | ||
Varicella | 474 | ||
Chickenpox in the immunocompromised patient | 476 | ||
Chickenpox and HIV infection | 476 | ||
Chickenpox during pregnancy | 477 | ||
Congenital and neonatal chickenpox | 477 | ||
Maternal varicella | 477 | ||
First trimester. | 477 | ||
Second trimester. | 477 | ||
Near birth. | 477 | ||
Laboratory diagnosis | 477 | ||
Rapid PCR. | 477 | ||
Culture. | 477 | ||
Serology. | 477 | ||
Varicella vaccine | 477 | ||
Treatment | 478 | ||
Acyclovir | 478 | ||
Children and adolescents. | 478 | ||
Adults. | 478 | ||
Immunocompromised patients. | 478 | ||
VZIG. | 478 | ||
Gammaglobulin. | 478 | ||
Herpes zoster | 479 | ||
Herpes zoster after varicella immunization | 483 | ||
Herpes zoster and HIV infection | 483 | ||
Herpes zoster during pregnancy | 483 | ||
Syndromes | 483 | ||
Ophthalmic zoster | 483 | ||
Clinical presentation. | 483 | ||
Eye involvement. | 484 | ||
Ramsay Hunt syndrome. | 484 | ||
Sacral zoster (S2, S3, or S4 dermatomes). | 485 | ||
Complications | 485 | ||
Pain and postherpetic neuralgia. | 485 | ||
Duration of pain. | 486 | ||
Pathophysiology of pain. | 486 | ||
Dissemination. | 486 | ||
Motor paresis. | 486 | ||
Encephalitis. | 486 | ||
Necrosis, infection, and scarring. | 486 | ||
Pregnancy | 487 | ||
Differential diagnosis | 487 | ||
Herpes simplex. | 487 | ||
Poison ivy. | 487 | ||
“Zoster sine herpete.” | 487 | ||
Cellulitis. | 487 | ||
Laboratory diagnosis | 487 | ||
Varicella–zoster vaccine. | 487 | ||
Treatment | 487 | ||
Treatment strategy. | 487 | ||
Topical therapy. | 487 | ||
Antiviral drugs. | 487 | ||
Topical acyclovir. | 488 | ||
Valacyclovir (Valtrex). | 488 | ||
Famciclovir (Famvir). | 488 | ||
Oral and intravenous acyclovir. | 488 | ||
Acyclovir-resistant infection. | 488 | ||
Disseminated herpes zoster in the immunocompromised host. | 488 | ||
Oral steroids. | 488 | ||
Nerve blocks. | 488 | ||
Treatment of postherpetic neuralgia | 489 | ||
Chapter\t| 13 | Superficial fungal infections | 491 | ||
Dermatophyte fungal infections | 491 | ||
Tinea | 495 | ||
Tinea of the foot | 495 | ||
Clinical presentations. | 495 | ||
Interdigital tinea pedis (toe web infection). | 495 | ||
Two feet-one hand syndrome | 496 | ||
Treatment. | 496 | ||
Chronic scaly infection of the plantar surface. | 497 | ||
Acute vesicular tinea pedis. | 497 | ||
Pitted keratolysis | 498 | ||
Tinea of the groin | 499 | ||
Differential diagnosis | 501 | ||
Intertrigo. | 501 | ||
Erythrasma. | 501 | ||
Treatment for tinea of the groin. | 501 | ||
Tinea of the body and face | 502 | ||
Round annular lesions. | 502 | ||
Tinea corporis (tinea gladiatorum) | 504 | ||
Deep inflammatory lesions. | 504 | ||
Treatment. | 505 | ||
Invasive dermatophyte infection. | 505 | ||
Tinea of the hand | 507 | ||
Tinea incognito | 508 | ||
Tinea of the scalp | 509 | ||
Organism and transmission. | 509 | ||
Hair shaft infection. | 509 | ||
Endothrix pattern of invasion. | 510 | ||
Ectothrix pattern of invasion. | 510 | ||
Microscopic patterns of hair invasion. | 510 | ||
Clinical patterns of infection. | 510 | ||
Trichophyton tonsurans | 510 | ||
Four patterns of infection. | 514 | ||
Noninflammatory black dot pattern. | 514 | ||
Inflammatory tinea capitis (kerion). | 514 | ||
Seborrheic dermatitis type. | 515 | ||
Pustular type. | 515 | ||
Differential diagnosis. | 515 | ||
Id reaction to therapy. | 516 | ||
Treatment. | 516 | ||
Tinea of the beard | 517 | ||
Superficial infection. | 517 | ||
Deep follicular infection. | 517 | ||
Treatment. | 517 | ||
Treatment of fungal infections | 522 | ||
Systemic agents (see tables 13-1 to 13-3) | 522 | ||
Griseofulvin. | 522 | ||
Adverse reactions. | 522 | ||
Allylamines. | 522 | ||
Terbinafine. | 522 | ||
Indications. | 523 | ||
Triazoles. | 523 | ||
Itraconazole (sporanox). | 523 | ||
Fluconazole (diflucan). | 523 | ||
Ketoconazole (nizoral). | 523 | ||
Candidiasis (moniliasis) | 523 | ||
Candidiasis of normally moist areas | 524 | ||
Vulvovaginitis | 524 | ||
Vaginal discharge | 524 | ||
Non–sexually-acquired discharge. | 524 | ||
Bacterial vaginosis. | 524 | ||
Sexually acquired discharge. | 524 | ||
Syndromic management. | 525 | ||
Optional tests. | 525 | ||
Monilial vulvovaginitis | 525 | ||
Clinical presentation. | 526 | ||
Management. | 526 | ||
Topical antifungal agents. | 526 | ||
Oral antifungal agents. | 527 | ||
Acute vaginal candidiasis. | 527 | ||
Patient preference. | 527 | ||
Partner treatment. | 527 | ||
Side effects. | 528 | ||
Pregnancy. | 528 | ||
Recurrent (resistant) disease | 528 | ||
Laboratory tests. | 528 | ||
Treating resistant cases. | 528 | ||
Resistant organisms. | 529 | ||
Oral candidiasis | 529 | ||
HIV infection. | 529 | ||
Infants. | 529 | ||
Adults. | 529 | ||
Treatment | 530 | ||
Fluconazole. | 530 | ||
Itraconazole. | 530 | ||
Clotrimazole (mycelex) troche. | 530 | ||
Ketoconazole (nizoral). | 530 | ||
Nystatin (mycostatin) oral suspension. | 530 | ||
Candida balanitis | 531 | ||
Treatment. | 531 | ||
Candidiasis of large skin folds | 532 | ||
Intertrigo | 534 | ||
Diaper candidiasis | 534 | ||
Treatment. | 534 | ||
Differential diagnosis. | 534 | ||
Candidiasis of small skin folds | 535 | ||
Finger and toe webs | 535 | ||
Angles of the mouth | 536 | ||
Treatment. | 536 | ||
Tinea versicolor | 537 | ||
Pityrosporum folliculitis | 540 | ||
Chapter\t| 14 | Exanthems and drug eruptions | 541 | ||
Exanthems | 544 | ||
Measles | 544 | ||
Typical measles | 545 | ||
Eruptive phase. | 546 | ||
Management of measles | 547 | ||
Vitamin A treatment. | 547 | ||
Immunity. | 547 | ||
Individuals exposed to disease. | 547 | ||
Use of human immunoglobin. | 547 | ||
Revaccination risks. | 547 | ||
Pregnancy. | 547 | ||
Hand-foot-and-mouth disease | 547 | ||
Scarlet fever | 549 | ||
Rubella | 552 | ||
Erythema infectiosum (parvovirus B19 infection) | 553 | ||
Roseola infantum (human herpesvirus 6 and 7 infection) | 556 | ||
Enteroviruses: Echovirus and coxsackievirus exanthems | 558 | ||
Kawasaki disease | 560 | ||
Superantigen toxin-mediated illnesses | 566 | ||
Toxic shock syndrome | 566 | ||
Cutaneous drug reactions | 568 | ||
Drug eruptions: Clinical patterns and most frequently causal drugs (box 14-6) | 570 | ||
Exanthems (maculopapular) | 570 | ||
Urticaria | 574 | ||
Pruritus | 574 | ||
Drug eruptions | 575 | ||
Acute generalized exanthematous pustulosis | 575 | ||
Acneiform (pustular) eruptions | 575 | ||
Eczema | 575 | ||
Fixed drug eruptions | 576 | ||
Blistering drug eruptions | 578 | ||
Erythema multiforme and toxic epidermal necrolysis | 578 | ||
Exfoliative erythroderma | 578 | ||
Lichenoid (lichen planus–like drug eruptions) | 578 | ||
Lupus erythematosus–like drug eruptions | 578 | ||
Chemotherapy-induced acral erythema | 579 | ||
Pigmentation | 579 | ||
Photosensitivity | 580 | ||
Vasculitis | 580 | ||
Lymphomatoid drug eruptions | 580 | ||
Skin eruptions associated with specific drugs | 580 | ||
Chapter\t| 15 | Infestations and bites | 581 | ||
Scabies | 582 | ||
Anatomic features, life cycle, and immunology | 582 | ||
Anatomic features | 582 | ||
Infestation and life cycle. | 583 | ||
Immunology. | 583 | ||
Clinical manifestations | 583 | ||
Primary lesions | 584 | ||
Burrow. | 584 | ||
Vesicles and papules. | 584 | ||
Secondary lesions | 584 | ||
Distribution | 586 | ||
Infants | 586 | ||
The elderly | 586 | ||
Crusted (Norwegian) scabies | 587 | ||
Diagnosis | 587 | ||
Burrow identification | 587 | ||
Sampling techniques and slide mount preparation | 588 | ||
Mineral oil mounts. | 588 | ||
Potassium hydroxide wet mounts. | 588 | ||
Adhesive tape. | 588 | ||
Treatment and management | 588 | ||
Permethrin | 588 | ||
Lindane | 588 | ||
Application technique for permethrin and lindane. | 588 | ||
Benzyl benzoate | 588 | ||
Crotamiton (eurax lotion) | 588 | ||
Sulfur | 589 | ||
Ivermectin (stromectol) | 589 | ||
Eradication program for nursing homes | 589 | ||
Management of complications | 589 | ||
Eczematous inflammation and pyoderma. | 589 | ||
Post-scabietic pruritus. | 589 | ||
Nodular scabies. | 589 | ||
Environmental management. | 589 | ||
Scabies in long-term care facilities | 589 | ||
Pediculosis | 590 | ||
Biology and life cycle | 590 | ||
Nits | 590 | ||
Clinical manifestations | 591 | ||
Pediculosis capitis | 591 | ||
Pediculosis corporis | 591 | ||
Eyelash infestation. | 591 | ||
Pediculosis pubis | 592 | ||
Diagnosis | 592 | ||
Combing | 592 | ||
Treatment | 593 | ||
Head, body, and pubic lice | 593 | ||
Permethrin. | 593 | ||
Pyrethrin. | 593 | ||
Malathion (ovide). | 593 | ||
Others. | 593 | ||
Lindane. | 593 | ||
Ivermectin. | 593 | ||
Trimethoprim/sulfamethoxazole (bactrim, septra). | 593 | ||
Nit removal | 593 | ||
Wet combing (bug busting). | 594 | ||
Pomades. | 594 | ||
Hot air. | 594 | ||
Fomite control. | 594 | ||
“No nit” policies | 594 | ||
Eye infestation | 594 | ||
Caterpillar dermatitis | 594 | ||
Clinical manifestations | 595 | ||
Distribution | 595 | ||
Diagnosis | 595 | ||
Treatment | 595 | ||
Spiders | 596 | ||
Black widow spider | 596 | ||
Clinical manifestations | 596 | ||
Treatment | 597 | ||
Immediate first aid. | 597 | ||
Antivenin. | 597 | ||
Muscle relaxants. | 597 | ||
Analgesics. | 597 | ||
Brown recluse spider | 598 | ||
Clinical manifestations | 598 | ||
Management | 599 | ||
Moderate to severe skin necrosis. | 599 | ||
Dapsone. | 599 | ||
Steroids. | 599 | ||
Surgery. | 599 | ||
Antivenin. | 599 | ||
Ticks | 600 | ||
Lyme disease and erythema migrans | 600 | ||
Geographic distribution | 600 | ||
Cutaneous manifestations | 602 | ||
Borrelia lymphocytoma. | 602 | ||
Acrodermatitis chronica atrophicans. | 602 | ||
Erythema migrans. | 602 | ||
Early and late disease. | 602 | ||
Three stages of infection | 602 | ||
Early localized disease (erythema migrans and flulike symptoms). | 604 | ||
Early disseminated disease (cardiac and neurologic disease). | 605 | ||
Cardiac disease. | 605 | ||
Chapter\t| 16 | Vesicular and bullous diseases | 635 | ||
Blisters | 635 | ||
Autoimmune blistering diseases | 635 | ||
Major blistering diseases | 635 | ||
Classification | 638 | ||
Epidermis | 638 | ||
The basement membrane zone (see figure 16-2) | 638 | ||
Basement membrane antigens and diseases. | 638 | ||
Diagnosis of bullous disorders | 638 | ||
Dermatitis herpetiformis and linear IgA bullous dermatosis | 642 | ||
Gluten-sensitive enteropathy | 644 | ||
Lymphoma | 644 | ||
Diagnosis of dermatitis herpetiformis | 644 | ||
Treatment | 645 | ||
Bullae in diabetic persons | 646 | ||
Pemphigus | 647 | ||
Pathophysiology | 647 | ||
Desmoglein | 647 | ||
Dsg1 and Dsg3 autoantibodies. | 647 | ||
Pemphigus vulgaris | 647 | ||
Pemphigus foliaceus, IgA pemphigus, and pemphigus erythematosus | 649 | ||
Pemphigus erythematosus | 649 | ||
Pemphigus foliaceus | 650 | ||
Fogo selvagem | 650 | ||
Diagnosis of pemphigus | 650 | ||
Treatment | 651 | ||
Approach to treatment | 652 | ||
Course and remission | 652 | ||
Risk of relapse | 653 | ||
Conclusions | 653 | ||
Determining remission and when to stop treatment. | 653 | ||
Pemphigus in association with other diseases | 653 | ||
Drug-induced versus drug-triggered pemphigus | 653 | ||
Paraneoplastic pemphigus (neoplasia-associated pemphigus) | 654 | ||
Laboratory diagnosis of paraneoplastic pemphigus | 654 | ||
Histologic studies. | 654 | ||
Direct immunofluorescence. | 654 | ||
Indirect immunofluorescence. | 654 | ||
The pemphigoid group of diseases | 655 | ||
Bullous pemphigoid | 655 | ||
Localized pemphigoid | 658 | ||
Diagnosis | 659 | ||
Treatment | 659 | ||
Plan of therapy. | 659 | ||
Topical therapy | 659 | ||
Oral cavity. | 659 | ||
Eyes. | 659 | ||
Intralesional therapy. | 659 | ||
Systemic therapy | 659 | ||
Dapsone. | 659 | ||
Corticosteroids. | 659 | ||
Immunosuppressive agents (adjuvant therapy). | 659 | ||
Etanercept. | 659 | ||
Antibiotics. | 659 | ||
Surgical therapy. | 659 | ||
Localized vulvar pemphigoid | 660 | ||
Benign chronic bullous dermatosis of childhood | 660 | ||
Herpes gestationis (pemphigoid gestationis) | 660 | ||
Pemphigoid-like disease | 661 | ||
Epidermolysis bullosa acquisita | 661 | ||
Benign familial chronic pemphigus | 662 | ||
Epidermolysis bullosa | 664 | ||
The newborn with blisters, pustules, erosions, and ulcerations | 665 | ||
Chapter\t| 17 | Connective tissue diseases | 671 | ||
Autoimmune diseases | 671 | ||
Connective tissue diseases | 672 | ||
Diagnosis | 672 | ||
Antinuclear antibody screening | 674 | ||
Connective tissue laboratory screening tests | 676 | ||
Lupus erythematosus | 678 | ||
Clinical classification (tables 17-5 and 17-6) | 678 | ||
Subsets of cutaneous lupus erythematosus | 680 | ||
Chronic cutaneous lupus erythematosus (discoid lupus erythematosus) | 682 | ||
Subacute cutaneous lupus erythematosus | 684 | ||
Systemic lupus erythematosus | 686 | ||
Overview of SLE | 686 | ||
Definition. | 686 | ||
Epidemiology. | 686 | ||
Clinical presentation. | 686 | ||
Laboratory findings. | 686 | ||
Diagnosis. | 686 | ||
Treatment. | 686 | ||
Cutaneous disease | 687 | ||
Other cutaneous signs of lupus erythematosus | 688 | ||
Diagnosis and management of cutaneous lupus erythematosus | 689 | ||
Neonatal lupus erythematosus | 690 | ||
Drug-induced lupus erythematosus | 691 | ||
Dermatomyositis and polymyositis | 692 | ||
Polymyositis | 692 | ||
Dermatomyositis | 693 | ||
Scleroderma | 700 | ||
Systemic sclerosis | 700 | ||
Chemically induced scleroderma | 700 | ||
Diffuse scleroderma | 700 | ||
Initial signs and symptoms. | 700 | ||
Skin. | 700 | ||
Raynaud’s phenomenon. | 703 | ||
Telangiectasias. | 703 | ||
Gastrointestinal tract. | 703 | ||
Lungs. | 703 | ||
Kidneys. | 703 | ||
Other organs. | 703 | ||
Prognosis. | 704 | ||
Crest syndrome | 704 | ||
Diagnosis of diffuse scleroderma | 704 | ||
Autoantibodies. | 704 | ||
Other studies. | 705 | ||
Office nailfold capillary microscopy | 706 | ||
Normal. | 706 | ||
Overlap syndromes (scleroderma, dermatomyositis). | 706 | ||
Mixed connective tissue disease. | 706 | ||
Lupus. | 706 | ||
Treatment | 706 | ||
Systemic therapy. | 706 | ||
Management of cutaneous disease. | 707 | ||
Localized scleroderma | 707 | ||
Morphea (figure 17-33) | 707 | ||
Laboratory diagnosis. | 708 | ||
Biopsy. | 708 | ||
Treatment. | 708 | ||
Linear scleroderma | 709 | ||
Laboratory. | 709 | ||
Treatment. | 709 | ||
En coup de sabre | 709 | ||
Chapter\t| 18 | Hypersensitivity syndromes and vasculitis | 710 | ||
Hypersensitivity syndromes | 710 | ||
Erythema multiforme | 710 | ||
Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum of disease | 714 | ||
Stevens-Johnson syndrome | 715 | ||
Toxic epidermal necrolysis | 717 | ||
Erythema nodosum | 720 | ||
Vasculitis | 722 | ||
Vasculitis of small vessels | 726 | ||
Hypersensitivity vasculitis | 727 | ||
Henoch-Schönlein purpura | 730 | ||
Neutrophilic dermatoses | 734 | ||
Sweet’s syndrome (acute febrile neutrophilic dermatosis) | 734 | ||
Erythema elevatum diutinum | 737 | ||
Pyoderma gangrenosum | 737 | ||
Schamberg’s disease | 740 | ||
Chapter\t| 19 | Light-related diseases and disorders of pigmentation | 741 | ||
Photobiology | 741 | ||
Sun-damaged skin | 743 | ||
Suntan and sunburn | 747 | ||
Sun protection | 747 | ||
Polymorphous light eruption | 750 | ||
Hydroa aestivale and hydroa vacciniforme | 752 | ||
Porphyrias | 754 | ||
Porphyria cutanea tarda | 756 | ||
Treatment | 758 | ||
Phlebotomy. | 758 | ||
Chloroquine. | 758 | ||
Pseudoporphyria | 758 | ||
Erythropoietic protoporphyria | 760 | ||
Phototoxic reactions | 761 | ||
Photoallergy | 764 | ||
Disorders of hypopigmentation | 764 | ||
Vitiligo | 764 | ||
Guidelines for the treatment of vitiligo | 767 | ||
Children. | 767 | ||
Adults. | 767 | ||
Narrow-band UVB. | 768 | ||
Response to treatment. | 768 | ||
Photochemotherapy. | 768 | ||
Topical therapy. | 768 | ||
Immunomodulators. | 768 | ||
Excimer laser. | 768 | ||
Grafting and transplantation. | 768 | ||
Systemic steroids. | 768 | ||
Cosmetics. | 768 | ||
Depigmentation of remaining normal skin. | 768 | ||
Idiopathic guttate hypomelanosis | 769 | ||
Nevus anemicus | 770 | ||
Tuberous sclerosis | 770 | ||
Pityriasis alba | 771 | ||
Disorders of hyperpigmentation | 771 | ||
Freckles | 771 | ||
Lentigo in children | 771 | ||
Lentigo in adults | 771 | ||
Melasma | 772 | ||
Café-au-lait spots | 774 | ||
Diabetic dermopathy | 775 | ||
Erythema ab igne | 775 | ||
Chapter\t| 20 | Benign skin tumors | 776 | ||
Seborrheic keratosis | 776 | ||
Stucco keratoses | 784 | ||
Skin tags (acrochordon) and polyps | 784 | ||
Dermatosis papulosa nigra | 786 | ||
Cutaneous horn | 786 | ||
Dermatofibroma | 787 | ||
Hypertrophic scars and keloids | 788 | ||
Keratoacanthoma | 790 | ||
Epidermal nevus | 792 | ||
Nevus sebaceous | 794 | ||
Chondrodermatitis nodularis helicis | 795 | ||
Epidermal cyst | 796 | ||
Pilar cyst (wen) | 798 | ||
Senile sebaceous hyperplasia | 799 | ||
Syringoma | 800 | ||
Chapter\t| 21 | Premalignant and malignant nonmelanoma skin tumors | 801 | ||
Basal cell carcinoma | 801 | ||
Pathophysiology | 803 | ||
Histologic characteristics | 803 | ||
Clinical types | 803 | ||
Management and risk of recurrence | 808 | ||
Recurrent basal cell carcinoma | 810 | ||
Clinical presentation | 810 | ||
Histologic type. | 810 | ||
Location. | 810 | ||
Size. | 810 | ||
Treatment of basal cell carcinoma | 810 | ||
Actinic keratosis | 812 | ||
Squamous cell carcinoma in situ | 820 | ||
Bowen’s disease | 821 | ||
Erythroplasia of Queyrat | 823 | ||
Arsenical keratoses and other arsenic-related skin diseases | 824 | ||
Squamous cell carcinoma | 824 | ||
Leukoplakia | 829 | ||
Verrucous carcinoma | 830 | ||
Primary cutaneous lymphomas | 831 | ||
Cutaneous T-cell lymphoma | 832 | ||
Paget’s disease of the breast | 843 | ||
Extramammary Paget’s disease | 844 | ||
Cutaneous metastasis | 845 | ||
Chapter\t| 22 | Nevi and malignant melanoma | 847 | ||
Melanocytic nevi | 847 | ||
Common moles | 848 | ||
Management | 850 | ||
Suspicious lesions. | 850 | ||
Nevi. | 850 | ||
Recurrent previously excised nevi (pseudomelanoma). | 850 | ||
Nevi with small dark spots. | 850 | ||
Special forms | 850 | ||
Atypical nevi | 856 | ||
Classification of atypical melanocytic nevi | 857 | ||
Clinical classification | 857 | ||
Clinical features of atypical moles | 858 | ||
Morphology. | 858 | ||
Surface characteristics. | 858 | ||
Development and distribution. | 858 | ||
Histologic characteristics. | 858 | ||
Management. | 858 | ||
Malignant melanoma | 860 | ||
Superficial spreading melanoma | 863 | ||
Nodular melanoma | 866 | ||
Lentigo maligna melanoma | 868 | ||
Acral-lentiginous melanoma | 870 | ||
Benign lesions that resemble melanoma | 871 | ||
Lesion examination | 871 | ||
Observation plus magnification plus dermoscopy. | 871 | ||
Screening for melanoma. | 871 | ||
Management of melanoma | 872 | ||
Biopsy | 872 | ||
Histologic findings and progression | 872 | ||
Radial growth phase tumors. | 872 | ||
Vertical growth phase tumors. | 873 | ||
Tumor thickness (Breslow microstage). | 873 | ||
Ulceration. | 873 | ||
Tumor thickness (Clark level). | 873 | ||
Pathology report. | 873 | ||
Mitotic rate. | 873 | ||
Tumor-infiltrating lymphocytes. | 873 | ||
Histologic regression. | 873 | ||
Angiolymphatic invasion and angiotropism. | 873 | ||
Special stains. | 873 | ||
Surgical therapy | 874 | ||
Excision after biopsy (resection margins) | 874 | ||
Metastatic staging and prognosis | 874 | ||
Sentinel lymph node biopsy. | 874 | ||
Indication. | 874 | ||
Procedure. | 874 | ||
Elective lymph node dissection. | 874 | ||
Initial diagnostic workup | 874 | ||
Staging and prognosis | 875 | ||
Staging for localized melanoma: Stages I and II | 875 | ||
Melanoma thickness | 875 | ||
Ulceration | 875 | ||
Pathologic staging of lymph nodes | 875 | ||
Follow-up examinations | 879 | ||
Follow-up intervals | 879 | ||
Medical treatment | 879 | ||
Treatment of lentigo maligna | 879 | ||
Dermoscopy | 880 | ||
Chapter\t| 23 | Vascular tumors and malformations | 891 | ||
Congenital vascular lesions | 891 | ||
Hemangiomas of infancy | 892 | ||
Superficial hemangiomas | 892 | ||
Management | 893 | ||
Nonintervention. | 893 | ||
Treating ulcers and rapidly proliferating lesions. | 893 | ||
Local wound care. | 893 | ||
Infection. | 894 | ||
Corticosteroids. | 894 | ||
Intralesional steroids. | 894 | ||
Lasers. | 895 | ||
Topical imiquimod. | 895 | ||
Surgery. | 895 | ||
Interferon alfa-2b. | 895 | ||
Deep hemangiomas | 896 | ||
Kasabach-Merritt syndrome. | 896 | ||
Hemangiomas associated with congenital abnormalities. | 896 | ||
Malformations | 898 | ||
Nevus flammeus (port-wine stains) | 898 | ||
Systemic syndromes. | 898 | ||
Sturge-Weber syndrome. | 902 | ||
Klippel-Trénaunay syndrome. | 902 | ||
Treatment. | 902 | ||
Lasers. | 902 | ||
Cosmetics. | 902 | ||
Salmon patches | 902 | ||
Acquired vascular lesions | 904 | ||
Cherry angioma | 904 | ||
Angiokeratomas | 904 | ||
Venous lake | 905 | ||
Lymphangioma circumscriptum | 905 | ||
Pyogenic granuloma (lobular capillary hemangioma) | 906 | ||
Bacillary angiomatosis | 906 | ||
Kaposi’s sarcoma | 907 | ||
Telangiectasias | 910 | ||
Spider angiomas | 910 | ||
Hereditary hemorrhagic telangiectasia | 911 | ||
Scleroderma | 911 | ||
Unilateral nevoid telangiectasia syndrome | 912 | ||
Generalized essential telangiectasia | 912 | ||
Chapter\t| 24 | Hair diseases | 913 | ||
Anatomy | 913 | ||
Physiology | 915 | ||
Evaluation of hair loss | 917 | ||
Generalized hair loss | 920 | ||
Localized hair loss | 922 | ||
Androgenetic alopecia in men (male pattern baldness) | 922 | ||
Adrenal androgenic female pattern alopecia | 924 | ||
Hirsutism | 926 | ||
Alopecia areata | 932 | ||
Prevalence | 932 | ||
Clinical presentation. | 932 | ||
Psychologic implications. | 933 | ||
Nail changes. | 933 | ||
Prognosis. | 933 | ||
Differential diagnosis. | 933 | ||
Etiology. | 933 | ||
Immunologic factors. | 933 | ||
Pathology. | 933 | ||
Treatment. | 934 | ||
Observation. | 934 | ||
Topical steroids. | 934 | ||
Intralesional injections. | 934 | ||
Minoxidil (topical solution). | 934 | ||
Anthralin. | 934 | ||
Topical immunotherapy. | 934 | ||
Systemic corticosteroids. | 934 | ||
Cyclosporine. | 934 | ||
Hair weaves and wigs. | 934 | ||
Trichotillomania | 936 | ||
Traction (cosmetic) alopecia | 937 | ||
Scarring alopecia | 938 | ||
Chronic cutaneous lupus erythematosus | 939 | ||
Lichen planopilaris (figure 24-19) | 940 | ||
Lichen planopilaris with frontal sclerosing alopecia | 940 | ||
Pseudopelade (figure 24-20) | 941 | ||
Folliculitis decalvans (figures 24-21 and 24-22) | 942 | ||
Dissecting cellulitis (figures 24-23 and 24-24) | 943 | ||
Acne keloidalis | 944 | ||
Tufted folliculitis (figures 24-27 and 24-28). | 945 | ||
Acne necrotica | 946 | ||
Erosive pustular dermatosis | 946 | ||
Trichomycosis | 946 | ||
Chapter\t| 25 | Nail diseases | 947 | ||
Anatomy and physiology | 947 | ||
Normal variations | 950 | ||
Nail disorders associated with skin disease | 951 | ||
Acquired disorders | 953 | ||
Bacterial and viral infections | 953 | ||
Fungal nail infections | 956 | ||
Treatment | 959 | ||
Oral agents: Terbinafine, itraconazole, fluconazole. | 959 | ||
Continuous terbinafine. | 959 | ||
Prognostic factors. | 959 | ||
Response to treatment. | 959 | ||
Preventing recurrence. | 959 | ||
Drug interactions. | 961 | ||
Laboratory monitoring. | 961 | ||
Safety of oral agents. | 961 | ||
Recurrence rates. | 961 | ||
Mechanical reduction of infected nail plate. | 961 | ||
Surgical removal. | 961 | ||
Nonsurgical avulsion of nail dystrophies. | 961 | ||
Trauma | 962 | ||
Onycholysis | 962 | ||
Treatment. | 962 | ||
Photoonycholysis. | 963 | ||
Nail and cuticle biting | 963 | ||
Nail plate excoriation | 963 | ||
Hangnail | 963 | ||
Ingrown toenail | 963 | ||
Treatment | 963 | ||
Ingrown nail without inflammation. | 963 | ||
Ingrown nail with inflammation. | 964 | ||
Recurrent ingrown nail. | 964 | ||
Subungual hematoma | 964 | ||
Nail hypertrophy | 964 | ||
White spots or bands | 964 | ||
Distal plate splitting (brittle nails) | 965 | ||
Habit-tic deformity | 965 | ||
Median nail dystrophy | 966 | ||
Pincer nails (curvature) | 966 | ||
The nail and internal disease | 966 | ||
Color and drug-induced changes | 969 | ||
Congenital anomalies | 969 | ||
Tumors | 970 | ||
Chapter\t| 26 | Cutaneous manifestations of internal disease | 974 | ||
Cutaneous manifestations of diabetes mellitus | 974 | ||
Necrobiosis lipoidica | 974 | ||
Granuloma annulare | 976 | ||
Acanthosis nigricans | 978 | ||
Xanthomas and dyslipoproteinemia | 980 | ||
Neurofibromatosis | 983 | ||
Tuberous sclerosis | 987 | ||
Internal cancer and skin disease | 990 | ||
Cutaneous paraneoplastic syndromes | 990 | ||
Familial cancer syndromes | 990 | ||
Cowden disease (multiple hamartoma syndrome) | 996 | ||
Muir-Torre syndrome | 997 | ||
Gardner’s syndrome | 997 | ||
Chapter\t| 27 | Dermatologic surgical procedures | 999 | ||
Antibiotic prophylaxis | 1001 | ||
Local anesthesia | 1001 | ||
Hemostasis | 1002 | ||
Wound healing | 1002 | ||
Postoperative wound care | 1005 | ||
Partial- and full-thickness open wounds | 1005 | ||
Sutured wounds | 1005 | ||
Office | 1005 | ||
Home. | 1005 | ||
Excess granulation tissue. | 1005 | ||
Scarlet red gauze. | 1005 | ||
Scar formation. | 1005 | ||
Skin biopsy | 1006 | ||
Punch biopsy | 1006 | ||
Shave biopsy and shave excision | 1006 | ||
Simple scissor excision | 1008 | ||
Electrodesiccation and curettage | 1009 | ||
Techniques | 1009 | ||
Curettage | 1010 | ||
Techniques—curettage | 1010 | ||
Techniques—electrodesiccation and curettage of basal cell carcinoma | 1010 | ||
Blunt dissection | 1011 | ||
Technique | 1011 | ||
Cryosurgery | 1012 | ||
Technique | 1012 | ||
Extraction of cysts | 1013 | ||
Technique | 1013 | ||
Mohs’ micrographic surgery | 1014 | ||
Technique | 1014 | ||
Chemical peels | 1015 | ||
Dermal and subdermal fillers | 1016 | ||
Liposuction | 1016 | ||
Lasers | 1016 | ||
Intense pulsed light | 1018 | ||
Botulinum toxin | 1018 | ||
Appendix A Bioterrorism | 1019 | ||
Appendix B dermatology and the recently returned traveler | 1024 | ||
Index | I-1 | ||
A | I-1 | ||
B | I-4 | ||
C | I-5 | ||
D | I-7 | ||
E | I-8 | ||
F | I-9 | ||
G | I-10 | ||
H | I-11 | ||
I | I-13 | ||
J | I-14 | ||
K | I-14 | ||
L | I-14 | ||
M | I-16 | ||
N | I-18 | ||
O | I-19 | ||
P | I-20 | ||
R | I-23 | ||
S | I-24 | ||
T | I-27 | ||
U | I-28 | ||
V | I-29 | ||
W | I-29 | ||
X | I-30 | ||
Y | I-30 | ||
Z | I-30 |